Metabolic events associated with the preparation of the fetus for independent life.

The metabolic changes late in fetal development that are essential for neonatal survival are discussed. In many species gluconeogenesis develops before birth but provides substrate for intracellular biosynthesis and not for glucose production because of low activities of glucose 6-phosphate translocase. At the time of glycogen deposition in species with a relatively mature brain at birth the translocase develops and glucagon and adrenaline can stimulate glucose production and synthesis to elevate blood glucose concentrations both pre- and postnatally. The other metabolic fuel accumulated before birth, fat, can also be mobilized prenatally and in fetuses that are relatively mature at birth it may be used as an alternative fuel. The fetal rat brain can oxidize fatty acids and the brain of fetuses such as that of the guinea-pig and man can oxidize ketone bodies before birth. The timing and degree of oxidation of ketone bodies relates to the timing of myelination and protects the brain against hypoglycaemia. These late changes in development are associated with a sharp increase in plasma cortisol and adrenaline concentrations and a high fetal insulin concentration.